Clinton Lights Up Antismoking Debate

NEW YORK
— THIS is the moment antitobacco advocates have long waited for and the tobacco industry has dreaded.

President Clinton's decision to declare nicotine an addictive drug, subject to regulation by the Food and Drug Administration (FDA), could be the most important antitobacco step since 1964, when the Surgeon General declared that smoking was a leading cause of death and disease.

Clinton's announcement yesterday was framed within the context of limiting smoking by teenagers. It is likely to result in a much broader, more explosive debate within Congress, however, and poses political risks for Clinton in the South.

The regulatory proposals, "put all the Democrats in North Carolina - especially the white Democrats - at great risk. It gives the Republicans some talking points," says professor Black.

Antitobacco advocates have long contended that tobacco, with its jolt of nicotine, should be regulated by the FDA. But the tobacco industry countered that there is not enough scientific evidence that nicotine is addictive. The FDA has apparently convinced a health-conscientious president that nicotine is sufficiently addictive to be regulated.

The FDA's initial actions, after a 90 day public comment period, will concentrate on halting tobacco sales to the underage. According to published reports, this includes:

*Forcing the tobacco industry to fund a $100 million education campaign aimed at halting youth smoking. This would be the largest youth antismoking program in the country, but would be only a small part of the $6 billion the industry spends on advertising.

*Tobacco ads in youth-oriented publications would be limited to black and white texts with no pictures. Limited teen access to vending machines is also likely to be part of the program.

*Outdoor tobacco ads would be forbidden within 1,000 feet of schools and playgrounds. Past surveys have found a large volume of bright cigarette advertising at small stores close to schools.

The tobacco industry says it will try to find voluntary ways to limit sales to minors. Recent surveys indicate that a larger percentage of teens are now smoking. Yesterday, Philip Morris said all packs would carry a notice that sale to minors is forbidden.

But the tobacco industry is more worried about regulation by the FDA than the teen-smoking issue.

"The FDA does not have jurisdiction, a lawsuit is likely," says Brennan Dawson, a spokeswoman for the Tobacco Institute.

If the courts agree that the FDA does have authority to regulate tobacco, "it could lead to further action in the future," says Dr. Gregory Connolly, director of the Massachusetts Tobacco Control Board.

For example, the FDA could adapt still tighter regulation on the sale of tobacco in order to cut down on smoking by children. Connolly says the FDA could also decide the industry needs to do a better job of disclosing the risks of smoking. "The tobacco industry has kept the adult smoker in the dark," says Connolly.

Over the long term, Connolly says the FDA could dramatically change the nature of smoking. For example, the FDA could require that nicotine in cigarettes be below the level of addiction. "The long term consequences are severe," he says.

This is exactly what the industry is afraid of. Ms. Dawson notes that the FDA must rule that a drug is safe and effective. "This is something they have already said they cannot do," says Dawson, adding, "[FDA Chairman] Kessler has said it may mean the removal of [tabacco products] from the marketplace."

FDA regulation could have a major impact on the multimillion dollar tobacco liability lawsuits dogging the industry. In the past, juries have agreed that smokers assumed the risk when they used the product. If cigarettes are declared addictive, "juries may take another look at risk," predicts Connolly.

According to the Raleigh News and Observer, an FDA draft document estimates the proposed changes would cost the tobacco industry $370 million the first year and $1.4 billion and 1,000 jobs over the next ten years as fewer people smoke.

Demographic changes, however, favor Clinton's move. In 1964, fifty percent of all adult males were smokers. Today, only 25 percent of adult males smoke. In addition, a recent survey by the American Lung Association found that 83 percent of the public support the FDA setting health and safety standards for tobacco products.

Despite this shift, the industry still has enormous political muscle. Sen. Bob Dole, the Republican presidential front-runner, has long supported the tobacco industry.

In the South, the issue may hurt Democrats. Sixty-five percent of all tobacco grown in the US is produced in North Carolina and Kentucky.

North Carolina Gov. Jim Hunt, a Democrat, is up for reelection. In 1996, the Kentucky statehouse, now held by a Democrat, will be up for grabs. The current lieutenant governor of Kentucky, who hopes to capture the governorship, opposed Clinton's decision.